Is there evidence of an association between postnatal distress and premenstrual symptoms?

Background There is a widely held assumption in the literature that a well-established link exists between postnatal depressive and premenstrual symptoms. However, on examination of existing research, certain methodological limitations were identified including inadequate methods of assessment and a heavy reliance upon the retrospective assessment of either postnatal or premenstrual symptoms, giving rise to concern regarding the validity of any conclusions.

Methods A community sample of 63 women completed a daily menstrual symptom diary for two consecutive months. Women's Edinburgh Postnatal Depression Scale score, recorded 1–3 years previously, was provided by their Health Visitor.

Results Only one participant showed evidence of both postnatal and premenstrual distress when using an EPDS cut-off of > 12 and defined criteria for premenstrual symptom assessment. When scores were treated as a continuum, there was no association between postnatal distress and psychological premenstrual symptoms and only a trend towards significance between postnatal distress and physical premenstrual symptoms.

Limitations Due to the recruitment method, there is some uncertainty regarding the overall response rate. Although this was not a large sample, it compares favourably with many other studies where daily data are collected. The particular focus was examining whether postnatal depressive symptoms predict premenstrual distress (not vice versa).

Conclusions This study found little evidence to support the widely held assumption of a clear relationship between postnatal distress and premenstrual symptoms.